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As traced by Uichael Bradbury in his recently published monograph, The Concept of a BZood-Brain Barrier, the idea of a scientific challenge is just about as old as the twentieth century. Curiously, it remains undefined. Is it a structure or structures as some use the term, or is it a reciprocal per meability, a force-flow relationship, as do others, or is it a group of processes, some more specialized than others? Depend ing upon the observer, the method, and what is observed, it seems to be each of these or all. This Symposium takes as its focus of interest the micro vasculature of the brain and includes considerations of blood flow, the properties of vessel walls and the control of flow and permeability. In addition perturbations that change the characteristics of the flow of materials are given attention. By changing the usual focus of interest, the organizers, Drs. Suddith and Eisenberg, have given a fresh outlook to the subject and now, by publication of the Proceedings, have arranged for wide availability of these interesting papers. Keasley Welch v PREFACE A symposium on the cerebral microvasculature and its function in the blood-brain barrier was held at The University of Texas Medical Branch, Galveston, in the summer of 1979. Investigators from the United States and Europe met to discuss their recent work.
This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.
Recognition that aging is not the accumulation of disease, but rather comprises fundamental biological processes that are amenable to experimental study, is the basis for the recent growth of experimental biogerontology. As increasingly sophisticated studies provide greater understanding of what occurs in the aging brain and how these changes occur
Up-to-date discussion of the etiology, diagnosis, treatment, and prevention of this common cause of stroke and cognitive impairment.
Encyclopedia of Cardiovascular Research and Medicine, Four Volume Set offers researchers over 200 articles covering every aspect of cardiovascular research and medicine, including fully annotated figures, abundant color illustrations and links to supplementary datasets and references. With contributions from top experts in the field, this book is the most reputable and easily searchable resource of cardiovascular-focused basic and translational content for students, researchers, clinicians and teaching faculty across the biomedical and medical sciences. The panel of authors chosen from an international board of leading scholars renders the text trustworthy, contemporary and representative of the global scientific expertise in these domains. The book's thematic structuring of sections and in-depth breakdown of topics encourages user-friendly, easily searchable chapters. Cross-references to related articles and links to further reading and references will further guide readers to a full understanding of the topics under discussion. Readers will find an unparalleled, one-stop resource exploring all major aspects of cardiovascular research and medicine. Presents comprehensive coverage of every aspect of cardiovascular medicine and research Offers readers a broad, interdisciplinary overview of the concepts in cardiovascular research and medicine with applications across biomedical research Includes reputable, foundational content on genetics, cancer, immunology, cell biology and molecular biology Provides a multi-media enriched color-illustrated text with high quality images, graphs and tables.
Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme
Brain dysfunction is a major clinical problem in intensive care, with potentially debilitating long-term consequences for post-ICU patients of any age. The resulting extended length of stay in the ICU and post-discharge cognitive dysfunction are now recognized as major healthcare burdens. This comprehensive clinical text provides intensivists and neurologists with a practical review of the pathophysiology of brain dysfunction and a thorough account of the diagnostic and therapeutic options available. Initial sections review the epidemiology, outcomes, relevant behavioral neurology and biological mechanisms of brain dysfunction. Subsequent sections evaluate the available diagnostic options and preventative and therapeutic interventions, with a final section on clinical encephalopathy syndromes encountered in the ICU. Each chapter is rich in illustrations, with an executive summary and a helpful glossary of terms. Brain Disorders in Critical Illness is a seminal reference for all physicians and neuroscientists interested in the care and outcome of severely ill patients.
Written and edited by the world's foremost authorities, the Second Edition of this landmark work is a current, comprehensive reference on cerebral blood flow and metabolism. The book covers the entire field in a systematic and coherent way and synthesizes the diverse body of basic science and clinical literature. The reader will gain a complete understanding of the anatomical, physiological, and pharmacological bases of the cerebral circulation, its regulation in health and disease, and the pathophysiological disturbances occurring in cerebrovascular disorders. Coverage includes stimulating discussions of future directions for research and therapeutic intervention.
The endothelium, a monolayer of endothelial cells, constitutes the inner cellular lining of the blood vessels (arteries, veins and capillaries) and the lymphatic system, and therefore is in direct contact with the blood/lymph and the circulating cells. The endothelium is a major player in the control of blood fluidity, platelet aggregation and vascular tone, a major actor in the regulation of immunology, inflammation and angiogenesis, and an important metabolizing and an endocrine organ. Endothelial cells controls vascular tone, and thereby blood flow, by synthesizing and releasing relaxing and contracting factors such as nitric oxide, metabolites of arachidonic acid via the cyclooxygenases, lipoxygenases and cytochrome P450 pathways, various peptides (endothelin, urotensin, CNP, adrenomedullin, etc.), adenosine, purines, reactive oxygen species and so on. Additionally, endothelial ectoenzymes are required steps in the generation of vasoactive hormones such as angiotensin II. An endothelial dysfunction linked to an imbalance in the synthesis and/or the release of these various endothelial factors may explain the initiation of cardiovascular pathologies (from hypertension to atherosclerosis) or their development and perpetuation. Table of Contents: Introduction / Multiple Functions of the Endothelial Cells / Calcium Signaling in Vascular Cells and Cell-to-Cell Communications / Endothelium-Dependent Regulation of Vascular Tone / Conclusion / References
Core Topics in Neuroanesthesia and Neurointensive Care is an authoritative and practical clinical text that offers clear diagnostic and management guidance for a wide range of neuroanesthesia and neurocritical care problems. With coverage of every aspect of the discipline by outstanding world experts, this should be the first book to which practitioners turn for easily accessible and definitive advice. Initial sections cover relevant anatomy, physiology and pharmacology, intraoperative and critical care monitoring and neuroimaging. These are followed by detailed sections covering all aspects of neuroanesthesia and neurointensive care in both adult and pediatric patients. The final chapter discusses ethical and legal issues. Each chapter delivers a state-of-the art review of clinical practice, including outcome data when available. Enhanced throughout with numerous clinical photographs and line drawings, this practical and accessible text is key reading for trainee and consultant anesthetists and critical care specialists.